Coxarthrosis, or degenerative disease of the hip joint, is one of the most serious pathologies of the musculoskeletal system. Due to the large size of the joint structures, the pain and discomfort are much more severe than when other joints are affected. The consequences of the pathology are also serious: if the destruction of the joints of small bones causes a lot of discomfort, arthrosis of the hip joint without treatment is a direct path to disability. Only proper therapy, and sometimes surgery, will help a person not lose the ability to walk.
What is hip osteoarthritis?
Coxarthrosis, osteoarthritis, osteoarthritis of the hip joint are synonyms of the same pathological process that occurs in the area of the thighs on one or both sides. In modern medicine, pathology is also called osteoarthritis - it was previously believed that inflammation was not characteristic of degenerative processes, but more accurate studies have shown the opposite. Affected articular cartilage tissues release inflammatory elements (interleukins), so osteoarthritis is another correct term.
The disease is characterized by such signs:
- It progresses constantly, passing from one stage to another,
- It leads to persistent pain, limited joint mobility,
- Causes deformation of bone surfaces, partial or complete destruction of hyaline cartilage,
- In the advanced stage, it is more characteristic of the elderly, but often begins after the age of 40,
- Symptoms of the pathology are present in 70% of people over 75 years of age,
- Women are more likely to suffer from the disease.
A joint is a mechanism in which there are parts that rub together. Due to a decrease in the quality or quantity of the lubrication (inter-articular fluid), the contact surfaces wear out. Small cracks appear in the cartilage, then they are destroyed, and instead of healthy tissue, a callus appears. Such growths do not allow the leg to move normally, its functions are lost.
Reasons for the development of the disease
Arthrosis of the right or left thigh region can be primary or secondary, and the first option is typical for older people. The disease of the primary form develops over decades, is associated with age-related wear and destruction of cartilage.
Secondary coxarthrosis has other causes and can start even in a young person. It is associated with the resulting inflammation (infectious, autoimmune), which drives the appearance of the pathology. Also, the cause may be trauma to the hip (hematoma, dislocation, bone fracture). Other possible causes of the secondary form:
- Operations in this anatomical zone,
- Diabetes mellitus and other serious metabolic pathologies,
- hormonal diseases,
- Congenital and acquired forms of curvature and displacement of the bones,
- hip dysplasia in a child
- Protrusion of the acetabulum, necrosis of the femoral head,
- Vascular diseases of a systemic nature, leading to a deterioration in the nutrition of cartilage,
- Bone tuberculosis, rheumatoid arthritis,
- gout, Perthes disease,
- Tumors are benign and malignant.
Symptoms of osteoarthritis of the hip joint in any form will appear faster if the risk factors act on the body:
- Constant stress, nervous shocks, depressions and worries,
- Obesity, even moderately overweight,
- unfavorable inheritance,
- Physical inactivity, sedentary work or certain professions with a high joint load,
- Excessive physical loads (force), professional sports.
disease symptoms
The development of arthrosis of the hip joint and its symptoms cannot be ignored. Even at an early stage, the disease makes itself felt and, above all, pain. Pain in emerging and progressive osteoarthritis of the hip joint increases as the disease progresses from one stage to another. They appear in the area of the thighs, they give to the knee, to the groin, even to the lower abdomen. Usually after sleeping, the pain subsides, but at an advanced stage it can be present all the time. On palpation, pain is not always felt, because joint damage can begin with deeply located parts.
Other possible signs of the disease:
- The creak that appears when moving, sometimes even with a slight,
- Lameness, change in gait,
- Shortening of the leg on the side where there is arthrosis of the hip joint,
- Stiffness of movements, limited rotation, leg movement.
As development proceeds, other signs of pathology appear. So, palpation gives a feeling of deformation of the bone, the presence of growths. During the examination, the doctor notes muscle atrophy, and the patient, even in everyday life, is forced to move with a cane, a crutch, due to pain and weakness of the limb.
In general, pain and other clinical manifestations are highly stage dependent. There are such stages of coxarthrosis:
- First.The symptoms are mild, but the initial changes are already noticeable during diagnosis. Synovial fluid becomes thicker, its volume decreases, the structure of cartilage changes towards the end of the stage. Small cracks appear, which the body tries to heal with the formation of small "calluses".
- Second.The pain at this stage is quite noticeable, the crunch, the restriction of motor function is obvious. Pain syndrome radiates to other parts of the body, spreads throughout the leg. The picture shows: thinning of the cartilage, narrowing of the distance between the bones, violation of the structure of the articular surfaces, sometimes displacement of the bone head from the cavity. The number of bone growths (osteophytes) increases.
- Third.The pain becomes unbearable, a person has severely limited movement, many stop moving altogether. The cartilage is almost completely destroyed, the muscles atrophy, the joint is severely deformed. Bone osteophytes look like spikes and irritate nerve endings.
What are the risks and complications?
It is easy to understand that if, with such a pathology as arthrosis of the hip joint, the symptoms and treatment are determined incorrectly, out of time, then this threatens disability. Unbearable pain syndrome, inability to walk, the need for constant care - this is what awaits a person without treatment for this disease.
Disability in case of damage to the thigh bones is established according to the severity of the disease, with the complete absence of the opportunity to work, they give the first group. These patients are shown surgery; this is the only effective method of treatment in such a situation. But even modern methods of operations can carry the risk of complications:
- infectious Infection,
- thrombosis, thromboembolism,
- Major blood loss.
The overall proportion of complications is small - 0. 5-2%, but they do occur. Most often, there is an infection of the prosthesis, which then needs to be replaced with a new one. That is why after the operation it is important to carry out a course of antibiotics.
Diagnostic measures for osteoarthritis.
It is recommended to seek help from a traumatologist, surgeon, orthopedist already at the first signs of damage to the femoral area. Initially, if hip osteoarthritis is suspected, the doctor performs physical tests:
- Palpate the upper part of the thigh, reveal pain points, bone osteophytes,
- Perform passive leg movements: flexion, extension, abduction and adduction to determine the range of possible movements.
Instrumental diagnosis will help to make a more accurate diagnosis and prescribe treatment for arthrosis of the hip joint. An X-ray is usually performed, the cheapest available method of investigation. It is recommended to take an X-ray on modern devices, or replace it with a CT scan, where the quality of the images is much higher. CT provides complete information on the state of the bones, cartilage and joint surfaces. If a detailed study of the state of the soft tissues is required (for example, when a nerve root is pinched), the specialist will prescribe an MRI.
Other possible diagnostic measures:
- joint Ultrasound,
- arthroscopy,
- blood test for rheumatoid factor,
- tuberculin tests,
- Biochemical analysis for suspicion of diabetes mellitus, gout.
It is very important to find the cause of secondary coxarthrosis, because without affecting it, it will not be possible to stop the course of the disease.
Treatment of arthrosis of the hip joint: drugs and physiotherapy.
If the signs of the disease are implicit, and it has not passed the stage of irreversible changes, then conservative treatment will help the patient. Drug therapy will also be necessary when hip joint osteoarthritis has become severe, as part of a course of treatment.
How to treat arthrosis of the hip joint? There is a program of pharmacological correction of the disease:
- Non-steroidal anti-inflammatory drugs. Pills or injections will help get rid of pain and inflammation. They cannot be used without control - the ability of cartilage to regenerate will decrease, in addition, the stomach and intestines suffer greatly from NSAIDs.
- Vascular drugs. Treatment with such means helps to strengthen the nutrition of cartilage and contributes to its restoration.
- Muscle relaxants. Indicated for spastic pain in the muscles caused by injuries in the thigh area.
- Chondroprotectors. Osteoarthritis of the hip joint requires obligatory and many months of taking such drugs. It is also necessary to apply injectable forms in courses, including injection into the joint cavity. An even more effective technique is the introduction of hyaluronic acid preparations into the joint.
- Corticosteroids. Used in extreme cases in the form of intra-articular injections. Such treatment is necessary if the symptoms become unbearable.
External agents (ointments, gels) for coxarthrosis are often ineffective due to the deep location of the joint. But physical therapy techniques are often used and provide great pain relief. UHF, laser therapy, magnetotherapy are performed in the thigh area, UHF, massage is performed. Also, with osteoarthritis, manual therapy is indicated, in some cases, joint traction.
Folk remedies for arthrosis.
Many people use alternative treatments for this pathology, although arthrosis of the hip joint does not respond well to various external methods. Only with a strong pain syndrome can compresses with isolation be applied to the sore spot, although this will be more distracting. Treatment of advanced and complicated arthrosis of the hip joint is best done with oral medications:
- Pour 100 g of dry cinquefoil grass with 500 ml of vodka, insist in the dark for 10 days, take 30 drops three times a day to relieve inflammation,
- Make jelly every day, in the absence of contraindications, make jelly regularly; dishes will serve no worse than chondroprotectors.
You can relieve pain with the help of such a compress. It is necessary to equally mix honey, medical bile, ammonia, glycerin, apply to the joint, tie with a warm cloth. Leave the compress on for 3 hours, then rinse it off.
Other methods and operation
For the complete treatment of osteoarthritis, it is very important to follow a proper diet, you will have to give up foods that interrupt the blood supply and impair the nutrition of cartilage. These are smoked meats, vinegar, salty foods, fried foods, as well as foods with preservatives, trans fats. But there should be more dishes with magnesium, potassium, iodine, calcium in the diet.
What is necessary to treat arthrosis of the hip joint is therapeutic exercises. All patients should perform daily warm-ups, special exercises in the supine position. For example, you should slowly raise your leg and keep it on the floor for a few seconds. It is important to exclude sudden movements, to avoid walking a lot and fast; with coxarthrosis, this will only increase the progression of the disease. A cane, crutches can be used to unload the joint, and an orthopedist may also recommend special orthoses to mitigate the load.
Treatment of arthrosis of the hip joint of the third and last stage is carried out only with the help of surgery, other methods are ineffective. In 95% of cases, the operation is successful, the movements of the legs are fully restored. But the prostheses are not eternal, their lifespan is up to 20 years, so the operation is the last resort. During arthroplasty, your own joint is replaced with an artificial one, and arthrosis of the hip joint no longer threatens you.
Prevention of coxarthrosis
In order not to carry out complex treatment of pathology, not to suffer from pain syndrome, it is important to start preventive measures from an early age. The prevention of coxarthrosis is especially important for those who are exposed to risk factors.
So that the blood supply to the cartilage does not suffer, you must:
- Eat with the inclusion of vegetable foods in the menu, a sufficient amount of lean meat, cottage cheese, jelly, foods with sour milk,
- Stop smoking, do not abuse alcohol,
- In sedentary work, warm up regularly, do simple exercises,
- Give up a sedentary lifestyle in favor of skiing, swimming, and other low-intensity aerobic activities.
In order for a person not to be affected by arthrosis of the hip joint, body weight should be controlled, obesity and the appearance of even 5-10 extra pounds should be prevented; this seriously increases the load on the femoral area. Coxarthrosis can only be prevented with an integrated approach and a healthy lifestyle!